title: Epstein-Barr DNA serology and positron-emission tomography imaging of the head and neck in pediatric transplant recipients.
abstract: OBJECTIVE
  Epstein-Barr virus (EBV) infection is a potential precursor of post-transplantation lymphoproliferative disorder (PTLD) in the pediatric transplant patient. Positron-emission tomography (PET) imaging is increasingly utilized in this population to monitor for neoplasia and PTLD. We assess the association between EBV serum titers and Waldeyer's ring and cervical lymph node PET positivity in the pediatric transplant recipient.
  
  
  METHODS
  Retrospective analysis of EBV serology and PET imaging results in pediatric orthotopic liver transplantation (OLT) recipients.
  
  
  METHODS
  Imaging results and laboratory data were reviewed for all pediatric OLT recipients from January 2005 to July 2011 at a single institution. Charts were evaluated for PET positivity at Waldeyer's ring or cervical lymphatics, and for EBV serology results. Demographic data extracted include patient sex and age at transplantation.
  
  
  RESULTS
  A total of 122 pediatric OLT recipients were reviewed. Twelve patients (10%) underwent PET imaging. Overall, four patients (33%) had evidence of PET positivity at Waldeyer's ring or cervical lymphatics. Five patients (42%) had positive EBV serology. There was a significant association between PET imaging results and EBV DNA serology results (P = .01).
  
  
  CONCLUSIONS
  PTLD surveillance in the pediatric transplant recipient is an important component of long-term care in this population. Although PET imaging is a new modality in monitoring pediatric transplant recipients for early signs of PTLD, an association between EBV serology and PET imaging results appears to exist. With increased implementation, PET imaging will likely prove valuable in its ability to monitor the transplant recipient at risk for PTLD.
authors.affiliation: Department of Head and Neck Surgery, David Geffen School of Medicine at University of California Los Angeles, Los Angeles, California, U.S.A.
authors.forename: Douglas
authors.initials: D
authors.lastname: Sidell
authors.forename: Robert S
authors.initials: RS
authors.lastname: Venick
authors.forename: Nina L
authors.initials: NL
authors.lastname: Shapiro
mesh_terms: D002648:Child; D002675:Child, Preschool; D003287:Contrast Media; D004279:DNA, Viral / Q000097:blood*; D020031:Epstein-Barr Virus Infections / Q000097:blood* / Q000000981:diagnostic imaging*; D005260:Female; D019788:Fluorodeoxyglucose F18; D006084:Graft Rejection / Q000000981:diagnostic imaging* / Q000821:virology*; D006257:Head / Q000000981:diagnostic imaging*; D006801:Humans; D007223:Infant; D016031:Liver Transplantation; D008232:Lymphoproliferative Disorders / Q000000981:diagnostic imaging* / Q000821:virology*; D008297:Male; D064847:Multimodal Imaging; D009333:Neck / Q000000981:diagnostic imaging*; D016133:Polymerase Chain Reaction; D049268:Positron-Emission Tomography; D019275:Radiopharmaceuticals; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed
chemical_list: D003287:Contrast Media; D004279:DNA, Viral; D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18
keywords: Epstein-Barr; Pediatrics; positron-emission tomography; post-transplantation lymphoproliferative disorder; transplantation